Context: Hypertension, often termed the "silent killer", is a growing public health concern in India. Once considered a disease of old age, recent data indicate that children and adolescents are increasingly affected, highlighting an urgent need for preventive strategies at the population level.
Relevance of the Topic : Prelims: Key facts related to Hypertension.
About Hypertension
- High blood pressure, also called hypertension, is blood pressure that is higher than normal. It is a condition in which the force of the blood against the artery walls is too high.
- High blood pressure is consistently at 140/90 mm Hg or higher. It is common but can be serious if not treated.
- Hypertension typically progresses without symptoms, gradually damaging the heart, brain, and kidneys.
Risk factors for Hypertension:
- Unhealthy Diet: High intake of salt, processed, and packaged foods; alcohol and tobacco use.
- High Salt Consumption: Average Indian adolescents consume over 8 grams of salt/day whereas WHO recommends less than 5 grams/day even for adults
- Rising Childhood Obesity: Excess weight increases cardiac and vascular strain.
- Physical Inactivity: Sedentary lifestyle becoming the norm.
The risk factors also include non-modifiable factors like age, genetics, and co-existing conditions such as diabetes.
Key Trends in India
- Comprehensive National Nutrition Survey (2016-18): 7.3% of Indian adolescents already had hypertensive blood pressure levels, rising to 9.1% in urban areas.
- NFHS-5 (2019-21):
- 12% of teenagers aged 15-19 already exhibit elevated blood pressure.
- 21% women and 24% men aged 15 and above have elevated blood pressure. The rates are slightly higher in urban areas than in rural areas.
- A study conducted between 2019 and 2021 revealed that over one in four Indian adults has hypertension. Of these, only one-third are diagnosed, fewer than one in five are treated, and a mere one in 12 have their blood pressure under control.
Government Initiatives to Tackle Hypertension:
- Population-Based Screening (2016): Launched under the National Health Mission for early detection of NCDs, including hypertension.
- India Hypertension Control Initiative (IHCI, 2017): Joint initiative by MoHFW, ICMR, WHO India, and Resolve to Save Lives. It focuses on standard treatment protocols, uninterrupted medicine supply, task-sharing, and decentralized care at the primary level.
- Integration with NP-NCD: IHCI best practices merged into the National Programme for Prevention and Control of Non Communicable Diseases (NP-NCD) to enable real-time tracking of screening, treatment, and control outcomes down to village level.
- ‘75 by 25’ Target: Goal to bring 75 million people with hypertension or diabetes under standard care by 2025; 71 million already enrolled (as of 2025).
Solutions & Way Forward
- Strengthen Primary Healthcare Delivery: Ensure continuous availability of antihypertensive drugs at Ayushman Arogya Mandirs. Promote the use of validated, automated BP monitors for accurate diagnosis and monitoring.
- Enhance Digital Health Integration: Leverage ABHA (Ayushman Bharat Health Account) to track patient history and treatment across facilities for better continuity of care.
- Incentivize Screening and Follow-up: Expand and align incentives for frontline workers (CHOs, ASHAs) with outcomes such as diagnosis, treatment initiation, and BP control.
- Transform Mid Day Meal Scheme: Upgrade PM POSHAN into a nutrition + food literacy platform reaching 120 million children. Incorporate regionally-inspired, fresh menus and student participation in meal planning and preparation.
- Adopt Global Best Practices: Adapt Japan’s ShoKuiku model of food education and Vietnam’s school lunch reforms to instill healthy eating habits from a young age.
- Policy Actions: Increasing excise taxes on tobacco and alcohol, banning their advertisement, reducing salt in processed foods, eliminating trans fats, and promoting healthy eating and physical activity.